This is a study guide written by me for Medical Students. The content will take them all the way through final exams. I am a medical doctor graduated in 2020 in the top 20% of my class; based off these revision notes.
NB: when presenting your findings to a senior, give a short summary sentence with a
few positive and negative symptoms.
HP
HPC
Location of pain (unilateral, upper or lower extremity)
Timing of onset
Character of pain
Pain worse on exertion (uphill) or burning pain at night? This is indicative of
ischaemic pain
What distance are they able to walk?
What is the effect of rest on the pain?
How long ago were they at their baseline? This will establish the rate of
decline.
ASSOCIATED SYMPTOMS:
fatigue, numbness, pallor, hyperpigmentation, temp of skin, hair loss, ulcers or
gangrenous lesions, wound healing, intermittent claudication, impotence, post-
prandial GI pain, weight loss, chest pain and SOB.
PMH (ask specifically about the following as they increase the risk of vascular
disease)
Diabetes
Hypertension
Cardiovascular disease
Previous infarcts
Stroke
PVD
Dyslipidaemia
Virchow’s triad (immobilisation, endothelial injury and hypercoagulable states)
Pregnancy (is a hypercoagulable state)
Cancer (causes a hypercoagulable state)
FH
Hypercoagulable states
Family history of STEMI?
Family history of cancer
AAA
, Final year notes
SH
Pack years, alcohol and drugs
Stressors
Occupation
Home situation
Diet and exercise
Travel (i.e. immobilisation on a long-haul flight)
Ask patient to wiggle finger and toes for gross motor function
Palpation
Temperature (using back of hand assessing limb to limb)
Cap refill (should be <2 seconds)
Radial pulse
Radio radial delay
Brachial pulse
Carotid pulse after auscultating
Femoral pulse after auscultating (compare each side at the mid inguinal point
between the ASIS and pubic symphysis)
Radio-femoral delay
Popliteal pulse
Posterior tibial pulse (compare foot to foot posterior to medial malleolus of the tibia)
Dorsalis pedis (lateral to extensor hallucis longus tendon)
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